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骨髓增生异常综合征是怎么回事?怎样诊断和治疗?

时间:2013-05-31       来源:体育外围

一. 骨髓增生异常综合征是怎么回事?

骨髓增生异常综合征(myelodysplastic syndrome,MDS)是一组起源于造血干细胞恶性克隆性疾病。以骨髓病态造血及骨髓衰竭、高风险向急性转化为临床特征。MDS为老年性疾病,大部分患者年龄大于60岁。在80岁以上年龄人群中,年发病率可达到12/10万。男女均可患病。随着人们生活水平的提高和生活方式的改变,以及国家工业化程度的提高,该病的发生呈上升趋势。

mdsbingyinshangbushifenqueding,danzhuiwenbingshi,duoyoufanfuranfashi,duonianjiashishi,youjirongjihuoyoumojiechu,huoxinfangzhuangxiuhouduanqineiruzhushi。renweiyuyoujibenhuahewujiechumiqiexiangguan。shaoshuyanjiurenweiyubingduganranjibuliangjinshixiguanyouguan。erjifaxingmdsyibanshizhizhongliujingfangshejiwanhuajizhiliaohouyuanqifashengdeshangshubingbian。

youyushangshuzhibingyinsudezuoyongdaozhizaoxuexibaojiyinsunshang,gusuizhongxingchengkelongxingzaoxue,bingyucanliuzhengchangzaoxuexingchengjiangchizhuangtai。jitichanshengguodudetlinbaxibaomianyi,tongshizhenduicancunzhengchangxibaohekelongxibao,yifangmianzaochengzaoxuexibaoguodudiaowang,gusuiwuxiaozaoxue,waizhouxueyidaosanxijianshao。tongshiyizhiexingkelongbuzhiyulijixiangzhuanhua。yidancizhongpinghengbeidapo,zemdsxiangamlzhuanhua。

二.怎么知道患了MDS?

mdsyi,chuxue,jibumingyuanyindefareweizhuyaolinchuangbiaoxian。tijiankejianbutongchengdudemao,pixiayudianyuban,deng。bufenbingrenkejiangongmohuangranhuoganpizhongda。

体育外围 duoshubingrenbiaoxianweiquanxuexibao(hongxibao,baixibaohexuexiaoban)jianshaohuoliangxijianshao,shaoshuweidanchun、xuexiaobanjianshaohuobaixibaojianshao。gusuitupianduoshuxianshizengshenghuoyue,bufenzengshengzhengchang,shaoshuzengshengjiandi。gusuixianshibingtaizaoxue(jiushixibaoxingtaiguaiyi,buzhengchang)。bingtaixibaoyingzhandaogaixixibao10%yishangcaiyouzhenduanyiyi。 zaisuliaobaomaidegusuiqiepianzhongkeqingxibianbiegexixibaoxingtai。shiyinxianweiranse(gomori)jiancegusuixianweizuzhizengshengzhuangkuang,duoshumdsbingrengusuixianshizhongdaozhongdugusuixianweihua。 tongguochangguidna gdaifenxi,kezai40—50% deyuanfaxingmds he50-60%dejifaxingmdsfaxianransetiyichang。yizhengtiaoransetidesangshihuozengjia,huoransetipianduandediushizuiweichangjian。ru+8,-5/5q-,-7/7q-,20q-deng。zaoxueganzuxibaotiwaijiluopeiyang mdshuanzhegusuicd34+xibao(zaoxueganzuxibao)tiwaipeiyangjiluo(>40gexibao)xianzhujianshao,huobunengshengcheng,erjicu(<40gexibao)xianzhuzengduo,jicu/jiluobizhimingxianzenggao。

ruguoyou,ganranhuochuxuedelinchuangbiaoxian,waizhouxuexianshiyixidaosanxijianshao,gusuizengshenghuoyuehuozhengchang,shaoshuzengshengdixia,danhebingzhishaoyixiyishangbingtaizaoxue,bingtaixibaoxu>gaixixibao10%yishang。weishengsub12,yesuan,tieji,weishengsub6dengzhiliao1yuexuexiangwugaishan。nengpaichuqitayouleisibiaoxiandejibingjiukeyizhenduanmds。dangranyaodaozhuankeyiyuan,youzhuankeyishengzuomdsquantaojianchacainengjinxingquezhen。

三.怎样治疗MDS?

体育外围 zaiquezhenmdsdeshihou,yinggaiyinggaitongshianzhaoshijieweishengzuzhi(who)defenleibiaozhunheguojiyuhoujifenxitong(ipss)duibingrenjinxingyaxingdehuafenheweixiandudepinggu,cainengduibingrenjinxingzhenduixingdezhiliao。zheixuyaojinxingquanmiandepeitaojianchacainengjinxing。muqiantiyuwaiweiyinengkaizhanxiangguandejiance。quezhenmdshou,yibankejiyu1—2yuedezaoxueyuanliaobuchongzhiliao,ruyesuan,weishengsub12,tieji,weishengsub6deng。yifangmianzuoweiqitazhiliaodejibenbuchong,lingyifangmianhaikeyijinyibuchuwaiyixieyinxingyingyangxingxuexibaojianshaodebingren,mingquemdszhenduan。dangranruguogusuiyixianshitieliyouxibaozengduo,huobingrenyiyouduocishuxueshi,zetiedebuchongyaoxiaoxin。zaibuchongzaoxueyuanliaodetongshi,wangwanggenjubingrenxuexibaojianshaodejutiqingkuangjiyuxiangyingdexibaoyinzizhiliao,rujiyu,baixibaojianshao,xuexiaobanjianshaodechengdujiyuepo/g-csf/baijiesu11/tpozhiliao。dangran,duizhongdu,huodongxingchuxuedebingrenshidangjiyuxuezhipinshuzhu,rushaojiangxue,xuexiaobandeng。yingjinliangcaiyongdancaixuexiaoban,biyaoshiyingyongtepei(hlayizhi)dexuexiaobanyijianshaoshouzhetongzhongkangtidechansheng。xuezhipinyingjinliangzaixiaojilianggu60zhaoshehoushuzhu,yinweimdsbinglijingchangchuyumianyiquexianzhuangtai(youqishijieshouhualiaozhe),zaijiashanghlabuhe,youfashengshuxuexiangguanyizhiwuwukangsuzhubing(gvgd)keneng。

zhenduidiwei/zhongweibingrendechangyongzhiliaobaokuoxibaobaohujideyingyong。kangdiaowangyaowu、kangxueguanzengzhiyaowu、mianyidiaojieyaowudeng,zhuyaomudeshiweichibingrendexuexibaozaijinkenengzhengchangdefanwei,baozhengbingrennengzhengchangshenghuo,bingyanhuanjibingjinyibufazhan。

duiyijingxiangzhuanhuahuoyijingyouxiangzhuanhuaqushidebingren,yinggaijishicaiyonghualiaohuoqujiajihuayaowuzhiliaoshibingqingdeyikongzhihuoqudewanquanhuanjie。duinianjiqing,quanshenqingkuanghaodebingren,yingjinzaoshishizaoxueganxibaoyizhi。youkenengshibingrenhuodezhangqishengcun。

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